Spinal Cord Injury Following Minimally Invasive Spinal Decompression

Minimally invasive lumbar decompression (MILD) is an interventional procedure for the treatment of patients with symptomatic lumbar spinal stenosis. Spinal cord injury after MILD has not yet been reported in literature.

We describe a case of a 95-year-old woman who underwent the MILD procedure at the L1-L2 level for symptomatic lumbar spinal stenosis. Following the procedure, the patient noticed lower extremity weakness and numbness, suprapubic numbness, groin pain, and urinary retention. Emergent magnetic resonance imaging of the lumbar spine exhibited new cord signal change at T12-L1. She subsequently underwent emergent L1-S1 decompression with gradual improvement of symptoms.

Direct trauma to the cord or increased pressure in a severely stenotic canal from injectate volume may have contributed to this patient's injury. Consideration of the severity and location of stenosis is critical as these results may pose additional risk factors for injury with the MILD procedure.